The Other Half of the Family Planning Equation

As Father’s Day approaches I look back to when my wife and I first decided to have children. We married fairly late, both in our early 30s, so we planned to have our first child just a couple years after we married. It was an exciting time; much thought went into planning our family. We are now proud parents of two healthy and happy girls. It’s normal in the U.S. for both men and women to play an active role in planning their families; however, in much of the developing world that is not the case.

Involving men in international family planning programs is an uphill battle. There is a lack of information among men on the importance of delaying first birth, of spacing births, and of avoiding high parity births for the health of the woman and the child. Family planning saves lives and improves maternal and child health. In the developing world, an estimated 90 percent of infants whose mothers die after childbirth will die by their first birthday.

Men play an essential role as they are the gatekeepers in many countries to what women can and cannot do: whether women can use contraception or whether family resources should go to pay for other methods. A number of USAID’s programs address gender issues, focusing on improving male participation in family planning.

We are making progress. Twenty years ago in Kenya, 10 percent of women who were not using or planning to use family planning said that their husband’s disapproval of family planning was the main reason. Today, this percentage has been reduced to 6 percent. Meanwhile, countries like Nigeria have 10 percent of these women attributing non-use of family planning to husband’s disapproval. So while we have seen improvements, there is still much work to be done.

Educating men on the importance of family planning and birth spacing is only part of the equation. There should also be a greater emphasis on male methods, including condoms and vasectomy.

The challenge is many men around the world don’t have good health seeking behavior so we must get creative in our opportunities to reach men. For example, now that there is incontrovertible evidence that male circumcision significantly reduces acquisition of HIV by men, there are male circumcision programs for adult men blossoming all over sub-Saharan Africa. We should make sure there are no missed opportunities to speak to men about other health issues, including planning for their families.

This Sunday, as we celebrate fathers everywhere, let us not forget that men’s participation in planning for their families will result in better health and improved lives.

Great picture Scott! And of course an important message. Helping address the health seeking challenge among males is one the integrated population-health-environment programs are showing some success with. Where the point of entry initially comes with some of the NRM livelihood associated dimensions that are more familiar, there is some evidence of greater participation in the health dimensions over time. See D’Agnes et al. 2010 on the Philippines IPOPCORM program.